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The stability and comfort provided by the navigator multi-axial prosthetic foot with flexible keel ensures that activity level 2 users are safer on uneven ground. The ankle center is positioned anatomically to promote a natural gait from heel strike to toe off.

  • Activity level 1
  • Activity level 2
  • Suitable for outdoor use

Navigator Clinical Evidence Reference

Clinical Outcomes using Navigator

  • Mobility
    • Shorter keel allows for more consistent rollover radius of curvature, regardless of changing footwear1
    • The most energy efficient radius of curvature for a rollover shape has been identified as 30% of the walker’s leg length. For a person of a typical adult height between 1.5m and 1.8m, this equates to approximately 245-290mm. Navigator has a rollover shape of ~250mm1.

Clinical Outcomes using Multiflex-style ankles

  • Safety
    • Low stiffness at weight acceptance leads to early foot-flat and greater stability for lower mobility patients15
    • No loss of stability during standing with Multiflex than fixed ankle/foot16
    • Easier to walk on uneven ground with Multiflex than fixed ankle/foot16,17
    • Easier to walk up a slope with Multiflex than fixed ankle/foot16
  • Mobility
    • Little to no difference in gait mechanics compared to flexible, “energy storing” prosthetic feet18
    • Increased prosthetic ankle range-of-motion with Multiflex compared to fixed ankle/foot16,17,19-21
    • Increased prosthetic ankle power with Multiflex compared to fixed ankle/foot17
    • Prosthetic rollover shape closer to natural biomechanics than fixed ankle/foot19
    • Users can walk longer distances and report “smoother” gait with Multiflex compared to fixed ankle/foot17
    • Benefits in mobility for bilateral users17,19-21
  • Residual Limb Health
    • Equivalent socket comfort to higher technology, energy-storing feet22
  • Loading symmetry
    • Improved stance phase timing symmetry with Multiflex compared to fixed ankle/foot21
    • Reduced sound limb loading with Multiflex compared to fixed ankle/foot21
  • User satisfaction
    • Majority of users rate Multiflex as either “good” or “acceptable”23 and prefer Multiflex to fixed ankle/foot17

References

  • Full Reference Listing
    1. Curtze C, Hof AL, van Keeken HG, et al.

      Comparative roll-over analysis of prosthetic feet. J Biomech 2009; 42: 1746–1753.

    2. Moore R.

      Patient Evaluation of a Novel Prosthetic Foot with Hydraulic Ankle Aimed at Persons with Amputation with Lower Activity Levels. JPO J Prosthet Orthot 2017; 29: 44–47.

    3. Moore R.

      Effect on stance phase timing asymmetry in individuals with amputation using hydraulic ankle units. JPO J Prosthet Orthot 2016; 28: 44–48.

    4. Buckley JG, De Asha AR, Johnson L, et al.

      Understanding adaptive gait in lower-limb amputees: insights from multivariate analyses. J Neuroengineering Rehabil 2013; 10: 98.

    5. Sedki I, Moore R.

      Patient evaluation of the Echelon foot using the Seattle Prosthesis Evaluation Questionnaire. Prosthet Orthot Int 2013; 37: 250–254.

    6. Rogers JP, Strike SC, Wallace ES.

      The effect of prosthetic torsional stiffness on the golf swing kinematics of a left and a right‐sided trans‐tibial amputee. Prosthet Orthot Int 2004; 28: 121–131.

    7. Kobayashi T, Orendurff MS, Boone DA.

      Dynamic alignment of transtibial prostheses through visualization of socket reaction moments. Prosthet Orthot Int 2015; 39: 512–516.

    8. Wright DA, Marks L, Payne RC.

      A comparative study of the physiological costs of walking in ten bilateral amputees. Prosthet Orthot Int 2008; 32: 57–67.

    9. Vanicek N, Strike SC, Polman R.

      Kinematic differences exist between transtibial amputee fallers and non-fallers during downwards step transitioning - Natalie Vanicek, Siobhán C Strike, Remco Polman, 2015. ProsthetOrthot Int 2015; 39: 322–332.

    10. Barnett CT, Vanicek N, Polman R, et al.

      Kinematic gait adaptations in unilateral transtibial amputees during rehabilitation: Prosthetics and Orthotics International: Vol 33, No 2. Prosthet Orthot Int 2009; 33: 135–147.

    11. Emmelot CH, Spauwen PHM, Hol W, et al.

      Case study: Trans‐tibial amputation for reflex sympathetic dystrophy: Postoperative management. Prosthet Orthot Int 2000; 24: 79–82.

    12. Boonstra AM, Fidler V, Eisma WH.

      Walking speed of normal subjects and amputees: Aspects of validity of gait analysis. Prosthet Orthot Int 1993; 17: 78–82.

    13. Datta DD, Harris I, Heller B, et al.

      Gait, cost and time implications for changing from PTB to ICEX® sockets. Prosthet Orthot Int 2004; 28: 115–120.

    14. Castro M de, Soares D, Mendes E, et al.

      Center of Pressure Analysis During Gait of Elderly Adult Transfemoral Amputees. J Prosthet Orthot 2013; 25: 68–75.

    15. Major MJ, Scham J, Orendurff M.

      The effects of common footwear on stance-phase mechanical properties of the prosthetic foot-shoe system. Prosthet Orthot Int 2018; 42: 198–207.

    16. McNealy LL, Gard SA.

      Effect of prosthetic ankle units on the gait of persons with bilateral trans-femoral amputations. Prosthet Orthot Int 2008; 32: 111–126.

    17. Su P-F, Gard SA, Lipschutz RD, et al.

      Gait characteristics of persons with bilateral transtibial amputations. J Rehabil Res Dev 2007; 44: 491–502.

    18. Boonstra A, Fidler V, Spits G, et al.

      Comparison of gait using a Multiflex foot versus a Quantum foot in knee disarticulation amputees. Prosthet Orthot Int 1993; 17: 90–94.

    19. Gard SA, Su P-F, Lipschutz RD, et al.

      The Effect of Prosthetic Ankle Units on Roll-Over Shape Characteristics During Walking in Persons with Bilateral Transtibial Amputations. J Rehabil Res Dev 2011; 48: 1037.

    20. Major MJ, Stine RL, Gard SA.

      The effects of walking speed and prosthetic ankle adapters on upper extremity dynamics and stability-related parameters in bilateral transtibial amputee gait. Gait Posture 2013; 38:858–863.

    21. Van der Linden ML, Solomonidis SE, Spence WD, et al.

      A methodology for studying the effects of various types of prosthetic feet on the biomechanics of trans-femoral amputee gait. J Biomech 1999; 32: 877–889.

    22. Graham LE, Datta D, Heller B, et al.

      A comparative study of conventional and energy-storing prosthetic feet in high-functioning transfemoral amputees. Arch Phys Med Rehabil 2007; 88: 801–806.

    23. Mizuno N, Aoyama T, Nakajima A, et al.

      Functional evaluation by gait analysis of various ankle-foot assemblies used by below-knee amputees. Prosthet Orthot Int 1992; 16: 174–182

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